Frontline Clinic Administrator Perspectives on Extreme Weather Events, Clinic Operations, and Climate Resilience.

Climate-sensitive extreme weather events are increasingly impacting frontline clinic operations. We conducted a national, cross-sectional survey of 284 self-identified administrators and other staff at frontline clinics determining their attitudes toward climate change and the impacts, resilience, and preparedness of clinics for extreme weather events. Most respondents (80.

Single-cell and spatial transcriptomics illuminate bat immunity and barrier tissue evolution.

Bats have adapted to pathogens through diverse mechanisms, including increased resistance - rapid pathogen elimination, and tolerance - limiting tissue damage following infection. In the Egyptian fruit bat (an important model in comparative immunology) several mechanisms conferring disease tolerance were discovered, but mechanisms underpinning resistance remain poorly understood. Previous studies on other species suggested that elevated basal expression of innate immune genes may lead to increased resistance to infection.

Intrahepatic portosystemic shunt: salvage mechanism for oligohydramnios complicating fetal growth restriction.

Objective: Portosystemic shunts in growth-restricted fetuses are more common than previously thought. We aimed to describe fetuses with growth restriction and transient oligohydramnios in which a congenital intrahepatic portosystemic shunt (CIPSS) was noted during follow-up.

Methods: This was a retrospective study of all fetuses diagnosed with growth restriction and transient oligohydramnios during a 5-year period in a large tertiary referral center.

MOMENT registry: Patients with advanced non-small-cell lung cancer harboring exon 14 skipping treated with systemic therapy.

exon 14 ex14) skipping occurs in 3-4% of non-small-cell lung cancer (NSCLC) cases. Low frequency of this alteration necessitated open-label, single-arm trials to investigate MET inhibitors. Since broad MET biomarker testing was only recently introduced in many countries, there is a lack of historical real-world data from patients with ex14 skipping NSCLC receiving conventional therapies.

Cancer therapy and reproductive impact.

All patients where the cancer treatment has gonadotoxic potential should be referred for oncofertility advice. The effect of chemotherapy and radiotherapy on the human ovary can vary from no impact to full-blown premature ovarian failure due to hormonal and follicular depletion. Total contraindications to fertility cryopreservation include acute malignancy that requires immediate lifesaving therapy.

Highly purified-hMG versus rFSH in ovarian hyperstimulation in women undergoing elective fertility preservation: a retrospective cohort study.

Objective: To compare recombinant FSH (rFSH) with highly purified-human menopausal gonadotrophin (hp-hMG) on ovarian response in women undergoing elective fertility preservation (FP).

Methods: This retrospective study included 456 women who underwent elective FP with gonadotropin-releasing hormone (GnRH) antagonist or progestin-primed ovarian stimulation (PPOS) protocols between 01/2017-12/2021. Only the first treatment cycle of each woman was included.

Shared selection and genetic architecture drive strikingly repeatable evolution in long-term experimental hybrid populations.

The degree to which evolution repeats itself has implications regarding the major forces driving evolution and the potential for evolutionary biology to be a predictive (versus solely historical) science. To understand the factors that control evolutionary repeatability, we experimentally evolved four replicate hybrid populations of sunflowers at natural sites for up to 14 years and tracked ancestry across the genome. We found that there was very strong negative selection against introgressed ancestry in several chromosomes, but positive selection for introgressed ancestry in one chromosome.

Evaluating the Effect of Various Pure Tone Averages on Cochlear Implant Candidacy Screening.

Objective: To provide evidence to use an extended frequency pure tone average to screen for cochlear implant evaluation candidates as recommended by the American Cochlear Implant Alliance. Additionally, to determine whether traditional low frequency, high or low frequency, high frequency, or extended frequency pure tone average most accurately predicts cochlear implant candidates based on speech perception scores from aided AzBio sentence testing or aided consonant-nucleus-consonant (CNC) testing.

Method: Adults from a tertiary care center who completed aided sentence testing during cochlear implant evaluation between 2014 and 2024 were assessed.

Theory-driven assessment of cognitive flexibility in bulimia nervosa: a preliminary study.

Background: Cognitive flexibility (CF) is defined as the ability to switch efficiently between different concepts or tasks. Empirical evidence of CF in individuals with bulimia nervosa (BN), offers conflicting conclusions, attributed to how CF is conceptualized and operationalized. The aims of the current study were to compare CF performance of women with BN to healthy controls, utilising a CF model that includes three subtypes termed: task switching, switching sets and stimulus-response mapping.

The Plant Ionome as a Functional Trait: Variation across Bioclimatic Regions and Functional Groups.

Plant chemical composition is a trait gaining increasing importance in plant ecology. However, there is limited research on the patterns and drivers of its variation among different plant functional groups and bioclimatic regions. We conducted an analysis of ionomes utilising X-ray fluorescence on 83 plant species from four distinct functional groups (grasses, legumes, forbs and woody species); we marked plots across 15 sites located in both the desert and Mediterranean bioclimatic regions.

Functional myocardial assessment in cine cardiac computerized tomographic angiography using echocardiographic feature-tracking software in patients with and without significant coronary disease.

Introduction: Cardiac computerized tomographic angiography (CCTA) is perceived as a non-invasive tool for assessment of coronary vessel anatomy. Feature tracking echocardiography has recently emerged as a tool for assessment of regional and global left ventricular function. We aimed to explore the applicability of echocardiographic strain on CCTA cine clips and assess whether global and regional strain parameters are associated with the extent of coronary stenosis.

Superior Keratoconus in Attention-Deficit Hyperactivity Disorder (ADHD): A Case Report and Literature Review.

Keratoconus is a progressive corneal ectasia that may lead to severe visual impairment. Superior keratoconus (SK) is an uncommon form of the disease, and few cases have been reported thus far. We present an unusual SK case and a literature review of this rare diagnosis.

Understanding Predictors of Crohn's Disease: Determinants of Altered Barrier Function in Pre-Disease Phase of Crohn's Disease.

The pathogenesis of Crohn's disease (CD) remains unknown. The current working theory is that genetic susceptibility influences host-microbe interactions, resulting in chronic inflammation. Case-control studies fail to explain the triggers or pathogenesis of the disease, notably due to confounding factors in patients with established disease.

A time for sex: circadian regulation of mammalian sexual and reproductive function.

The circadian clock regulates physiological and biochemical processes in nearly every species. Sexual and reproductive behaviors are two processes controlled by the circadian timing system. Evidence supporting the importance of proper clock function on fertility comes from several lines of work demonstrating that misalignment of biological rhythms or disrupted function of the body's master clock, such as occurs from repeated shift work or chronic jet lag, negatively impacts reproduction by interfering with both male and female fertility.

Long-term mindfulness meditation increases occurrence of sensory and attention brain states.

Interest has been growing in the use of mindfulness meditation (MM) as a therapeutic practice, as accumulating evidence highlights its potential to effectively address a range of mental conditions. While many fMRI studies focused on neural activation and functional connectivity during meditation, the impact of long-term MM practice on spontaneous brain activity, and on the expression of resting state networks over time, remains unclear. Here, intrinsic functional network dynamics were compared between experienced meditators and meditation-naïve participants during rest.

Kinetics of Macroion Adsorption on Silica: Complementary Theoretical and Experimental Investigations for Poly-l-arginine.

A comprehensive approach enabling a quantitative interpretation of poly-l-arginine (PARG) adsorption kinetics at solid/electrolyte interfaces was developed. The first step involved all-atom molecular dynamics (MD) modeling of physicochemical characteristics yielding PARG molecule conformations, its contour length, and the cross-section area. It was also shown that PARG molecules, even in concentrated electrolyte solutions (100 mM NaCl), assume a largely elongated shape with an aspect ratio of 36.

En bloc resection of large bladder tumor: is it feasible and reasonable?

Purpose Of Review: Transurethral resection of bladder tumor (TURBT) remains the basis of bladder tumor diagnosis and an effective means of treating nonmuscle invasive bladder cancer (NMIBC). There are several limitations to this procedure: TURBT may cause free floating of malignant cells in the bladder and as a result re-implantation and early recurrence. Also, it does not allow the pathologist to define the correct spatial orientation of the specimen.

Differences in lasers and laser technologies: what does a clinician need to know?

Purpose Of Review: This review focuses on recent advancements in laser technologies used in urology, particularly in enucleation, vaporization, lithotripsy, and focal laser ablation (FLA). The growing use of the thulium fiber laser (TFL) and the development of pulsed thulium lasers (p-Tm:YAG) highlight the relevance of this review, as these innovations aim to improve precision and outcomes in urological procedures.

Recent Findings: Recent studies have shown the advantages of TFL in achieving precise tissue ablation, reduced retropulsion offered by the Moses technology in holmium lasers, and the potential of pulsed thulium lasers for more precise control of the effects on tissues.

A Bayesian Interpretation of CABANA and Other Randomized Controlled Trials for Catheter Ablation in Patients With Atrial Fibrillation.

Background: Catheter ablation improves symptoms and quality of life in atrial fibrillation patients, but its effect on adverse cardiovascular outcomes and mortality remains uncertain. Bayesian analysis of randomized controlled trials offers a deeper understanding of treatment effects beyond conventional p-value thresholds.

Methods: We conducted a post hoc Bayesian reanalysis of CABANA and four similar trials to estimate catheter ablation's effect on cardiovascular and survival outcomes.

Association between Physical Therapists' Attitudes and Beliefs and the Functional Outcomes of Patients with Low Back Pain: A Multilevel Analysis Study.

Objective: This study aimed to investigate the association of physical therapists' attitudes and beliefs about low back pain treatment outcomes within a publicly funded health care system.

Methods: Data from a national outpatient physical therapist service provider were analyzed. Functional status data were collected at intake and discharge.

Auxin treatment reduces inflorescences number and delays bud development in the alternate bearing Citrus cultivar Murcott mandarin.

Specific cultivars of many commercial fruit tree undergo cycles of heavy fruit load (ON-crop) one year, followed by low fruit load (OFF-crop) the next (termed alternate bearing). Fruit load may affect flowering at various developmental stages, and its presence is suggested to generate a flowering-inhibitory signal. In a previous report, we showed that the presence of fruit induces polar auxin transport from the fruit into the stem, interfering with indole acetic acid (IAA) release from the bud, and thus elevating its levels in the bud meristem.

Oral health disparities in early childhood and intergenerational gaps among noncitizen migrants, Arabs, and Jews in South Tel Aviv, Israel.

Introduction: Disparities in oral health are related to dental care knowledge, domestic oral hygiene practices and socioeconomic status. This cross-sectional study aimed to compare the oral hygiene and dental care practices of migrant, Arab, and Jewish children residing in Tel Aviv, Israel, and assess the influence of parental dental practices.

Methods: Data were collected from parents of children aged 3 to 6 years.